CASP Checklist: 10 questions to help you make sense of a Systematic Review

How to use this appraisal tool: Three broad issues need to be considered when appraising a
systematic review study:

Are the results of the study valid? (Section A)

What are the results? (Section B)
Will the results help locally? (Section C)

The 10 questions on the following pages are designed to help you think about these issues
systematically. The first two questions are screening questions and can be answered quickly.
If the answer to both is “yes”, it is worth proceeding with the remaining questions. There is
some degree of overlap between the questions, you are asked to record a “yes”, “no” or “can’t
tell” to most of the questions. A number of italicised prompts are given after each question.
These are designed to remind you why the question is important. Record your reasons for
your answers in the spaces provided.

About: These checklists were designed to be used as educational pedagogic tools, as part of a
workshop setting, therefore we do not suggest a scoring system. The core CASP checklists
(randomised controlled trial & systematic review) were based on JAMA 'Users’ guides to the
medical literature 1994 (adapted from Guyatt GH, Sackett DL, and Cook DJ), and piloted
with health care practitioners.
For each new checklist, a group of experts were assembled to develop and pilot the checklist
and the workshop format with which it would be used. Over the years overall adjustments
have been made to the format, but a recent survey of checklist users reiterated that the basic
format continues to be useful and appropriate.
Referencing: we recommend using the Harvard style citation, i.e.: Critical Appraisal Skills
Programme (2018). CASP (insert name of checklist i.e. Systematic Review) Checklist.
[online] Available at: URL. Accessed: Date Accessed.

©CASP this work is licensed under the Creative Commons Attribution – Non-Commercial-
Share A like. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc-
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Critical Appraisal Skills Programme (CASP) part of OAP Ltd www.casp-uk.net

Nama : Muhamad Iilham
Nim : C1AA23095
Kelas : 1B Sarjana Keperawatan
Studi dan Kutipan : Intervensi Keperawatan Pada Penderita Gagalginjal Kronik yang menjalani
Hemodialis
Link Sumber : https://www.journal.stikespemkabjombang.ac.id/index.php/jikep/article/view/451/411

Paper for appraisal and reference:

…………………………………………………………………………………………………….
Section A: Are the results of the review valid?

1. Did the review address a Yes HINT: An issue can be ‘focused’ In terms
clearly focused question? of
Can’t Tell • the population studied
• the intervention given
No √ • the outcome considered

Comments:
the text does not provide details regarding the research questions answered by the review. The text
only provides a general overview of the importance of nursing interventions in chronic renal failure
patients undergoing hemodialysis and the research that has been carried out in this regard

2. Did the authors look for the Yes √ HINT: ‘The best sort of studies’ would
right type of papers?  address the review’s question
Can’t Tell  have an appropriate study design
(usually RCTs for papers evaluating
No
interventions)

Comments:
These articles are research based on randomized controlled trials that are relevant to the topic of
nursing interventions in chronic kidney failure patients undergoing hemodialysis. Therefore, it can be
concluded that the author is looking for the right type of paper, namely research based on randomized
controlled trials which can provide stronger evidence in evaluating the effectiveness of the nursing
intervention

Is it worth continuing?

3. Do you think all the Yes HINT: Look for

important, relevant studies • which bibliographic databases were
were included? Can’t Tell √

2
 used
No • follow up from reference lists
• personal contact with experts
• unpublished as well as published studies
• non-English language studies

Comments:
The authors stated that they had collected six research articles based on randomized controlled trials
that met the inclusion criteria. This shows that the author has made an effort to search for and select
research that is relevant to the topic of nursing interventions in chronic kidney failure patients
undergoing hemodialysis.

4. Did the review’s authors do
enough to assess quality of
the included studies?
Yes √ HINT: The authors need to consider the
rigour of the studies they have identified.
Can’t Tell Lack of rigour may affect the studies’
results (“All that glisters is not gold”
No Merchant of Venice – Act II Scene 7)

Comments:
This review has followed PRISMA (Preferred Reporting Items for Systematic Reviews and
MetaAnalyses) guidelines, as mentioned in the text excerpt, so it is likely that the authors have paid
attention to the importance of assessing the quality of included studies. The PRISMA guidelines
emphasize the need to assess the quality of research included in systematic reviews. Assessment of
research quality in systematic reviews generally involves the use of existing research quality
assessment tools, such as risk of bias, internal validity, and external validity. Using this assessment
tool, review authors can consider the strengths and weaknesses of each study included in the review

5. If the results of the review Yes HINT: Consider whether

have been combined, was it
reasonable to do so?
• results were similar from study to study
Can’t Tell √ • results of all the included studies are
clearly displayed
No
• results of different studies are similar
• reasons for any variations in results are
discussed

Comments:
Depends on several factors, including the uniformity and quality of the studies included in the review,
as well as whether the data obtained can be combined statistically. If the studies included in the review
have similar designs and characteristics, and the data obtained can be integrated and analyzed
statistically, then combining the results of the reviews through meta-analysis can provide more robust
information about the effectiveness of nursing intervention

3
Section B: What are the results?

6. What are the overall results of the review? HINT: Consider

• If you are clear about the review’s
‘bottom line’ results
• what these are (numerically if
appropriate)
• how were the results expressed (NNT,
odds ratio etc.)

Comments:
The results obtained were six randomized controlled trial research articles that met the inclusion
criteria. Research articles suggest nursing interventions such as inhalation therapy, training
programs,foot massage, acupressure, use of cold dialysate, and music therapy. This intervention offers
results in managing complications that often occur in HD patients and an appropriate duration for the
application of the intradialytic phase

7. How precise are the results? HINT: Look at the confidence intervals, if
given

Comments:
This systematic review can be a reference for hemodialysis nurses and health service providers with
hemodialysis facilities to find out nursing interventions that have been tested and are evidence-based
interventions, especially in the intradialysis phase. It can also be the basis for collaborative action with
other health workers to improve service quality.

Section C: Will the results help locally?

8. Can the results be applied to Yes √ HINT: Consider whether

the local population?  the patients covered by the review could
Can’t Tell be sufficiently different to your
population to cause concern
No  your local setting is likely to differ
much from that of the review

Comments:
It is important to pay attention to whether the population in the studies reviewed in the systematic
review is similar to the local population to which the results are intended to be applied. If there are
significant differences in population characteristics, for example in terms of demographics, health
conditions, or socio-cultural factors, then the relevance of the results may be questioned.

9. Were all important outcomes Yes √ HINT: Consider whether

considered?

4
 Can’t Tell  there is other information you would
like to have seen
No

Comments:
Yes, written clearly using Times New Roman font, 11 spaces, 1. 1,942 articles were obtained from the
five databases, then double publications were obtained totaling 783 articles, resulting in 1,159 articles
that met the inclusion criteria, then screening was carried out again regarding the relevance of the
articles to the aim of this systematic review. And excluded a total of 1,131 articles, then 28 articles
were selected. To evaluate the quality of selected research articles, using the Critical Appraisal Skills
Program (CASP) six research articles were obtained that met the requirements. From these six articles,
it can be seen that the research was conducted in several countries such as Iran, Australia, the United
States, Malaysia and Turkey. Randomized Controlled Trial is the research method used (n=6).

10. Are the benefits worth the Yes √ HINT: Consider

harms and costs?  even if this is not addressed by the
Can’t Tell review, what do you think?

No

Comments:
Yes

RINGKASAN PENILAIAN :
Judul : Intervensi Keperawatan Pada Penderita Gagalginjal Kronik yang menjalani Hemodialis

Peneliti : Hayyu Sitoresmi¹ ², Andi Masyitha Irwan³, Elly Lilianty Sjattar³

Tujuan : untuk memberi pemahaman akan jenis-jenis intervensi keperawatan dalam fase
hemodialisis.

Hasil : diperoleh enam artikel penelitianrandomized controlled trialyang sesuai dengan kriteria
inklusi. Artikel penelitian mengemukakan intevensi keperawatan seperti terapi inhalasi,
training program, pijat kaki, akupresur, penggunaan dialisat dingin, danterapi musik. Intervensi
tersebut menawarkan hasil tertanganinya komplikasi yang sering terjadi pada pasien HD dan durasi
yang sesuai untuk diaplikasikan fase intradialitik.

Kesimpulan : Intervensi keperawatan dapat diapliaksikan untuk mengatasi keluhan mual, muntah,
nyeri, pruritus, kelemahan fisik, kram, dan gangguan psikologis. Namun perlu disesuaikan
dengan kondisi pasien dan koordinasi dengan petugas medis lain dalam meningkatkan kualitas
pelayanan.